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THE FIVE PILLARS OF INFORMATICS 1

1

The Five Pillars of Informatics

Position Paper: Masters Education in Health Informatics and Analytics and Transformational

Informatics

Dr. Suzanne Paone

Dr. Karen Bakuzonis

University of Arizona Global Campus School of Health Sciences

Master of Science in Informatics and Analytics (MSHIA)

August 2019

THE FIVE PILLARS OF INFORMATICS 2

2

The Five Pillars of Informatics

Call for Transformation

Current structures, cultures, and platforms in health and health services in the U.S. will

benefit from a transformational change. Amidst demands for transparency and improved quality

on the part of new generations of consumers’ traditional health organizations still trend low in

quality and cost performance metrics compared to global health systems. While the National call

for automation through the Center for Medicare and Medicaid’s Meaningful Use program

achieved levels of base transactional data gathering and pockets of quality improvement in health

provider systems, automation alone has done little to precipitate change. Furthermore,

government incentive programs hardly provide sustainable economic models. Clearly health

cost and quality problems have proven not to be a matter of pure investments in systems and

automation. There is a need to improve basic consumer trust in quality outcomes as basic as

medication error avoidance (McMains V., 2016). Likewise, while health care costs in the U.S.

have leveled off in the last few years, the industry, on the whole, is still a noncompetitive enigma

to most accomplished business leaders in other sectors of the economy as well as policy makers

and governing bodies.

What U.S. health care experiences in 2019 is not unlike what other sectors of the U.S.

economy have experienced in the past two decades. New models of doing business where

outperforming competitors on quality metrics while significantly reducing costs is the norm in

sectors such as financial services, retail, manufacturing, and hospitality to name a few. In these

industries, we see relatively standardized data collected through basic transactional business

processes that are now being used to improve the customer experience, sell more relevant

products, flatten hierarchical organizational structures and spawn new disruptive organizations in

THE FIVE PILLARS OF INFORMATICS 3

3

mature industries. Policy pundits debate financing and entitlement structures for U.S. health care

and important philosophical questions as to whether health care coverage is a right or a privilege.

While this is valuable discourse, creative citizens, within and external to, existing health systems

see the call for transformation in the U.S. health economy regardless of political disposition.

Informatics, HIT and Data Science

As early as 2011 the American Medical Informatics Association (AMIA) published a

broad framework for the discipline of informatics consisting of five domains comprised of

practice in the areas of bioinformatics and clinical research, consumer health informatics, clinical

informatics and informatics focused in public & population health practice (Discovering Health

Insights (n.d.). This position aligns the use of informatics capabilities such as information

systems, policies regarding information governance, process change and adoption of data driven

practice as transformative. Pillars evolve to support broad transformation in all aspects of health

care deliver and health related service.

This framework of five inter-related pillars of informatics practice sets the stage for what

we call Transformational Informatics practice (TI). Transformational Informatics practice is the

set of processes, technologies and leadership skills that allow disruption of current health

structures, systems, and processes and sets the stage for industry innovation. Likewise, the rapid

installation of transactional information platforms in the health industry facilitates the gathering

of data and allows stakeholders to be able to utilize data science principles such as data analytics

to drop powerful inferences from these data assess. As we discussed below, the pillars alone are

not enough. Optimal Transformational Informatics practice includes the strategic amalgamation

of the five pillars of health informatics along with transformative leadership education skills to

produce emotionally intelligent leaders in the field.

THE FIVE PILLARS OF INFORMATICS 4

4

Five Pillars of Transformational Informatics (TI)

In order for structures, processes and systems related to health, heath care and health

services to remain relevant in the U.S. in coming decades and serve a local and global citizenry,

there must a convergence of collaborative informatics practice housed in the Five Pillars of

Transformational Informatics. Simply said, evolving actors in sectors of the health economy

must innovate creative ways to transform processes, systems, and cultural structures. While

much innovation comes from creative inspiration, passion, and dedication, risks can be mitigated

and rewards expedited if leaders make data driven decisions. Actors may be financial policy

makers, CEOs of traditional hospital structures, surgeons evaluating persons for procedures,

genetic counseling consultants advising families or children of elderly parents striving to make

appropriate risk-benefit based decisions at a societal, organizational and/or individual level. To

date, many of these actors have made decisions based on emotion. In the Information Age, tools

and methods exist to empower these actors to evolve into leaders. Actors become leaders and

leaders facilitate positive change. Figure 1.0

Transformational Informatics Education (TIE)

Higher educational organizations and programs are societal structures that must undergo

a fundamental transformation to align with the expectations of a viable health economy.

Rigorous and data driven graduate level programs including both evidence-based content and

dynamic pedagogical methods are needed to prepare a new generation of transformational

leaders. These programs must include both the technical content elements of a rigorous program

grounded in all Five Informatics Pillars and also evidence in fields of management science and

leadership that address content in Change Management, Disruptive Innovation, Effective

communication and Transformational Leadership practice. As seen in Figure 1.0, in the case of

THE FIVE PILLARS OF INFORMATICS 5

5

TIE as applied to Health Informatics the foundation of graduate study lies in programs that

addresses all Five Pillars of Informatics practice. Similarly, the layer of the program that

facilities learners’ transformation as leaders lies in the execution of skills that employers

perceive as valuable in year after year surveys across organizations’ leaders:(NACE)

Just as the Nation’s heath cost/quality imperative was not as simple as implementing

electronic record platforms and revised coding standards, we posit that effective Health

Informatics studies are not as simple as linking curricula that cover the Five Pillars of Health

Informatics. As illustrated in Figure 1.0 the delivery of these content areas and their rich

histories of research and evidence must align with content in areas traditionally though of by

many biomedical and HIT educators and practitioners as organizational development or soft

skills. Implementing a health informatics curriculum that dutifully covers biomedical

informatics, consumer health, population and public health and clinical information systems is

not enough.

Original research in all areas of educational program development and effectiveness with

regard to information driven leadership transformation is imperative. Like other societal

structures, educational organizations and their partners should be data driven in their pursuits to

transform existing educational structures in the develop of innovative graduate educational

models. Many societal entities have a vested interested in efficient higher education and

effective workforce development and should support rigorous research in this domain. In the

meantime, an early set of Guiding Attributes for effective Transformational Informatics

Education (TIE) in graduate studies specific to health and health services is evolving.

THE FIVE PILLARS OF INFORMATICS 6

6

These attributes specific to health informatics and analytics graduate education include but

are not limited to the following:

1. Multidisciplinary: Programs that facilitate multidisciplinary learning inclusive of

professionals from backgrounds in health care delivery (providers & administrators,

information technology, health and non-healthcare backgrounds and health information

management (HIM)

2. Experiential: Educational cultures that support discourse, critical thinking, case-based,

experiential learning

3. Transforming: Programs that aim to support the transformation of learners during the

graduate educational process along the spectrum of advanced Emotional Intelligence (EI)

4. Integrative: Programs that integrate both historical evidence and research in the fields

represented by the Five Pillars as well as teaching and supporting learning in the realities

of disruptive change seen in the Information Age culture

5. Nimble: Structures and methods that are flexible, scalable and are built to leverage

unforeseen advancements in both learning & consumer-based technologies

In summary, as illustrated in Figure 2.0 graduate education in transformative informatics

practice the challenge for learners involves programs and content that are innovative, change

oriented, culturally competent in their delivery and emphasize the importance of data driven

decision making. Educational programs that are delivered utilizing this strategy effectively

integrate technical content in the field, such as the pillars of informatics in the health field along

with critical leadership skills that are necessary in the development of stakeholders who can

facilitate sweeping change. It is beholden upon every constituency who has a vested interest in

education to step back and assess both current programs and developing programs and

THE FIVE PILLARS OF INFORMATICS 7

7

educational models in this light as we continue to explore innovative ways to better serve

societies needs in the evolving Information Age.

THE FIVE PILLARS OF INFORMATICS 8

8

Appendix A

Figure 1.0

The Five Pillars of Transformational Health Informatics

Note: This figure illustrates how the five pillars of transformation impact organizational

transformation.

Five Pillars of Transformational Health Informatics

Change Management, Innovation, Effective

Communication, Transforming Leadership T

ra n

s la

ti o

n a

l

C lin

ic a

l R

e s e

a rc

h

C lin

ic a

l

C o

n s u

m e

r H

e a

lt h

P o

p u

la ti o

n /P

u b

lic

H e

a lt h

TransformationOrganizational Transformation is achieved through Transforming Leaders who enable change, manage communication and embrace innovation in their use of strategic information assets.

• Translational Bioinformatics enables innovation in biologic and computing science . • Clinical Research Informatics informs discovery and innovation. • Clinical Informatics enables change & improvements in people & systems processes. • Consumer Health Informatics empowers customers. • Population & Public Health Informatics facilitates societal and cultural focus.

Informatics Pillars

THE FIVE PILLARS OF INFORMATICS 9

9

Figure 2.0

Master of Science in Informatics and Analytics (MSHIA) Program Vision

Note: This figure illustrates the MSHIA program vision.

Curriculum, Faculty

and Learning

Community that

promotes cultural

relevance

Content and experiences

focused on probem

solving and innovative

curriculm elements

Emphasis on leading

change as health care and

health services industires

undergo dramatic

transformation

Experiences that focus

on data driven decision

making and critical

thinking

Transformational Informatics

THE FIVE PILLARS OF INFORMATICS 10

10

References

American Medical Informatics Association. (n.d.) Why informatics? Discovering health

insights: Accelerative healthcare transformation. AMIA: Informatics Professionals

Leading the Way. https://www.amia.org/why-informatics

McMains V. (2016) John Hopkins study suggests medical errors are third leading cause of death

in the U.S. https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death/

In your review of The Five Pillars of Informatics reflect on the various types of informatics solutions, such as clinical provider order entry (CPOE) implementations, patient portal implementations, or upgrades of patient management systems addressed as individual project initiatives in HIA601. Compare the program to your chosen IDN. As you examine each of the projects with your program, analyze how to implement these projects in tandem to best address the stated goals of the IDN. Consider the following: Are the systems being implemented in such a way that the IDN can gain measurable and sustainable cost reductions?

For this week’s assignment, you will select an IDN from the provided IDN scenarios. You will take the role of the program management office director (PMOD). In this role, you will create a program management plan that will encompass several projects. These projects are listed in each IDN scenario as “informatics implementation projects.” You will choose one informatics implementation project for which you will take on the role of project manager.

You should note that each informatics implementation project reflects a significant investment for the organization. It’s the job of the PMOD (you) to determine how each project and the program overall creates tangible benefits for the organization while controlling technology costs. Remember that while each project is a discrete informatics solution being implemented in the organization, the challenge for students is to assess the interrelationships and interdependencies between these projects as they form an informatics program.

Ensure you download The Five Pillars of Informatics (ATTACHED) white paper to guide your strategy for the IDN. To do this, consider the following questions:

• Which informatics pillars does your program most clearly reflect?

• Think about the composition of the IDN and the stated goals and objectives in the scenario: How will the implementation of multiple informatics solutions, in tandem, strategically enable that organization to meet these goals?

In your paper,

• Formulate an initial strategy to manage the informatics implementation projects as a comprehensive program for the chosen IDN.

• Analyze the challenges that you will face as you develop your informatics program strategy for the chosen IDN.

• Discuss the goals of the IDN and how they contribute to a competitive strategy for the organization.

• Explain how at least two of the health informatics pillars relate to the goals and competitive strategy of the IDN based on research in the field.

• Describe how each project in the informatics program individually contributes to achieving the goals of the IDN.

• Outline at least five interrelationships or dependencies between the projects in your informatics program.

• Compose an initial statement of the risk you may encounter with the informatics program. Please outline at least one technical, financial, and operational risk identified.

The Selection of Health Informatics Scenarios paper

• must be at least 7 double-spaced pages in length (not including title and references pages) and formatted according to APA Style.

• Must include at least 7 peer-review scholar articles plus the course textbook

• must include a separate title page with the following: o title of paper in bold font

▪ Space should appear between the title and the rest of the information on the title page.

o student’s name o name of institution (The University of Arizona Global Campus) o course name and number o instructor’s name o due date

Course Textbook:

Longest, B. B., Jr. (2015). Health program management: From development through

evaluation. (2nd ed.). John Wiley & Sons.

THE FIVE PILLARS OF INFORMATICS 1

1

The Five Pillars of Informatics

Position Paper: Masters Education in Health Informatics and Analytics and Transformational

Informatics

Dr. Suzanne Paone

Dr. Karen Bakuzonis

University of Arizona Global Campus School of Health Sciences

Master of Science in Informatics and Analytics (MSHIA)

August 2019

THE FIVE PILLARS OF INFORMATICS 2

2

The Five Pillars of Informatics

Call for Transformation

Current structures, cultures, and platforms in health and health services in the U.S. will

benefit from a transformational change. Amidst demands for transparency and improved quality

on the part of new generations of consumers’ traditional health organizations still trend low in

quality and cost performance metrics compared to global health systems. While the National call

for automation through the Center for Medicare and Medicaid’s Meaningful Use program

achieved levels of base transactional data gathering and pockets of quality improvement in health

provider systems, automation alone has done little to precipitate change. Furthermore,

government incentive programs hardly provide sustainable economic models. Clearly health

cost and quality problems have proven not to be a matter of pure investments in systems and

automation. There is a need to improve basic consumer trust in quality outcomes as basic as

medication error avoidance (McMains V., 2016). Likewise, while health care costs in the U.S.

have leveled off in the last few years, the industry, on the whole, is still a noncompetitive enigma

to most accomplished business leaders in other sectors of the economy as well as policy makers

and governing bodies.

What U.S. health care experiences in 2019 is not unlike what other sectors of the U.S.

economy have experienced in the past two decades. New models of doing business where

outperforming competitors on quality metrics while significantly reducing costs is the norm in

sectors such as financial services, retail, manufacturing, and hospitality to name a few. In these

industries, we see relatively standardized data collected through basic transactional business

processes that are now being used to improve the customer experience, sell more relevant

products, flatten hierarchical organizational structures and spawn new disruptive organizations in

THE FIVE PILLARS OF INFORMATICS 3

3

mature industries. Policy pundits debate financing and entitlement structures for U.S. health care

and important philosophical questions as to whether health care coverage is a right or a privilege.

While this is valuable discourse, creative citizens, within and external to, existing health systems

see the call for transformation in the U.S. health economy regardless of political disposition.

Informatics, HIT and Data Science

As early as 2011 the American Medical Informatics Association (AMIA) published a

broad framework for the discipline of informatics consisting of five domains comprised of

practice in the areas of bioinformatics and clinical research, consumer health informatics, clinical

informatics and informatics focused in public & population health practice (Discovering Health

Insights (n.d.). This position aligns the use of informatics capabilities such as information

systems, policies regarding information governance, process change and adoption of data driven

practice as transformative. Pillars evolve to support broad transformation in all aspects of health

care deliver and health related service.

This framework of five inter-related pillars of informatics practice sets the stage for what

we call Transformational Informatics practice (TI). Transformational Informatics practice is the

set of processes, technologies and leadership skills that allow disruption of current health

structures, systems, and processes and sets the stage for industry innovation. Likewise, the rapid

installation of transactional information platforms in the health industry facilitates the gathering

of data and allows stakeholders to be able to utilize data science principles such as data analytics

to drop powerful inferences from these data assess. As we discussed below, the pillars alone are

not enough. Optimal Transformational Informatics practice includes the strategic amalgamation

of the five pillars of health informatics along with transformative leadership education skills to

produce emotionally intelligent leaders in the field.

THE FIVE PILLARS OF INFORMATICS 4

4

Five Pillars of Transformational Informatics (TI)

In order for structures, processes and systems related to health, heath care and health

services to remain relevant in the U.S. in coming decades and serve a local and global citizenry,

there must a convergence of collaborative informatics practice housed in the Five Pillars of

Transformational Informatics. Simply said, evolving actors in sectors of the health economy

must innovate creative ways to transform processes, systems, and cultural structures. While

much innovation comes from creative inspiration, passion, and dedication, risks can be mitigated

and rewards expedited if leaders make data driven decisions. Actors may be financial policy

makers, CEOs of traditional hospital structures, surgeons evaluating persons for procedures,

genetic counseling consultants advising families or children of elderly parents striving to make

appropriate risk-benefit based decisions at a societal, organizational and/or individual level. To

date, many of these actors have made decisions based on emotion. In the Information Age, tools

and methods exist to empower these actors to evolve into leaders. Actors become leaders and

leaders facilitate positive change. Figure 1.0

Transformational Informatics Education (TIE)

Higher educational organizations and programs are societal structures that must undergo

a fundamental transformation to align with the expectations of a viable health economy.

Rigorous and data driven graduate level programs including both evidence-based content and

dynamic pedagogical methods are needed to prepare a new generation of transformational

leaders. These programs must include both the technical content elements of a rigorous program

grounded in all Five Informatics Pillars and also evidence in fields of management science and

leadership that address content in Change Management, Disruptive Innovation, Effective

communication and Transformational Leadership practice. As seen in Figure 1.0, in the case of

THE FIVE PILLARS OF INFORMATICS 5

5

TIE as applied to Health Informatics the foundation of graduate study lies in programs that

addresses all Five Pillars of Informatics practice. Similarly, the layer of the program that

facilities learners’ transformation as leaders lies in the execution of skills that employers

perceive as valuable in year after year surveys across organizations’ leaders:(NACE)

Just as the Nation’s heath cost/quality imperative was not as simple as implementing

electronic record platforms and revised coding standards, we posit that effective Health

Informatics studies are not as simple as linking curricula that cover the Five Pillars of Health

Informatics. As illustrated in Figure 1.0 the delivery of these content areas and their rich

histories of research and evidence must align with content in areas traditionally though of by

many biomedical and HIT educators and practitioners as organizational development or soft

skills. Implementing a health informatics curriculum that dutifully covers biomedical

informatics, consumer health, population and public health and clinical information systems is

not enough.

Original research in all areas of educational program development and effectiveness with

regard to information driven leadership transformation is imperative. Like other societal

structures, educational organizations and their partners should be data driven in their pursuits to

transform existing educational structures in the develop of innovative graduate educational

models. Many societal entities have a vested interested in efficient higher education and

effective workforce development and should support rigorous research in this domain. In the

meantime, an early set of Guiding Attributes for effective Transformational Informatics

Education (TIE) in graduate studies specific to health and health services is evolving.

THE FIVE PILLARS OF INFORMATICS 6

6

These attributes specific to health informatics and analytics graduate education include but

are not limited to the following:

1. Multidisciplinary: Programs that facilitate multidisciplinary learning inclusive of

professionals from backgrounds in health care delivery (providers & administrators,

information technology, health and non-healthcare backgrounds and health information

management (HIM)

2. Experiential: Educational cultures that support discourse, critical thinking, case-based,

experiential learning

3. Transforming: Programs that aim to support the transformation of learners during the

graduate educational process along the spectrum of advanced Emotional Intelligence (EI)

4. Integrative: Programs that integrate both historical evidence and research in the fields

represented by the Five Pillars as well as teaching and supporting learning in the realities

of disruptive change seen in the Information Age culture

5. Nimble: Structures and methods that are flexible, scalable and are built to leverage

unforeseen advancements in both learning & consumer-based technologies

In summary, as illustrated in Figure 2.0 graduate education in transformative informatics

practice the challenge for learners involves programs and content that are innovative, change

oriented, culturally competent in their delivery and emphasize the importance of data driven

decision making. Educational programs that are delivered utilizing this strategy effectively

integrate technical content in the field, such as the pillars of informatics in the health field along

with critical leadership skills that are necessary in the development of stakeholders who can

facilitate sweeping change. It is beholden upon every constituency who has a vested interest in

education to step back and assess both current programs and developing programs and

THE FIVE PILLARS OF INFORMATICS 7

7

educational models in this light as we continue to explore innovative ways to better serve

societies needs in the evolving Information Age.

THE FIVE PILLARS OF INFORMATICS 8

8

Appendix A

Figure 1.0

The Five Pillars of Transformational Health Informatics

Note: This figure illustrates how the five pillars of transformation impact organizational

transformation.

Five Pillars of Transformational Health Informatics

Change Management, Innovation, Effective

Communication, Transforming Leadership T

ra n

s la

ti o

n a

l

C lin

ic a

l R

e s e

a rc

h

C lin

ic a

l

C o

n s u

m e

r H

e a

lt h

P o

p u

la ti o

n /P

u b

lic

H e

a lt h

TransformationOrganizational Transformation is achieved through Transforming Leaders who enable change, manage communication and embrace innovation in their use of strategic information assets.

• Translational Bioinformatics enables innovation in biologic and computing science . • Clinical Research Informatics informs discovery and innovation. • Clinical Informatics enables change & improvements in people & systems processes. • Consumer Health Informatics empowers customers. • Population & Public Health Informatics facilitates societal and cultural focus.

Informatics Pillars

THE FIVE PILLARS OF INFORMATICS 9

9

Figure 2.0

Master of Science in Informatics and Analytics (MSHIA) Program Vision

Note: This figure illustrates the MSHIA program vision.

Curriculum, Faculty

and Learning

Community that

promotes cultural

relevance

Content and experiences

focused on probem

solving and innovative

curriculm elements

Emphasis on leading

change as health care and

health services industires

undergo dramatic

transformation

Experiences that focus

on data driven decision

making and critical

thinking

Transformational Informatics

THE FIVE PILLARS OF INFORMATICS 10

10

References

American Medical Informatics Association. (n.d.) Why informatics? Discovering health

insights: Accelerative healthcare transformation. AMIA: Informatics Professionals

Leading the Way. https://www.amia.org/why-informatics

McMains V. (2016) John Hopkins study suggests medical errors are third leading cause of death

in the U.S. https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death/